肝门部胆管癌术前胆汁回输联合肠内营养的应用价值

目的探讨术前胆汁回输联合肠内营养治疗对肝门部胆管癌根治性切除术的应用价值。方法选取肝门部胆管癌根治性切除手术患者53例,根据术前治疗方式的不同分为观察组(n=24)和对照组(n=29)。对照组患者术前仅接受常规治疗,观察组患者术前加行胆汁回输联合肠内营养。观察并记录2组患者手术时间、术中出血量、肝功能情况、术后住院时间及并发症发生情况。结果观察组患者手术前1天的总胆红素(total bilirubin,TBil)、丙氨酸转氨酶(alanine aminotransferase,ALT)及碱性磷酸酶(alkaline phosphatase,ALP)均比入院时有所下降(P<0.05);观察组患者的手术时间及术中出血量均优于对照组(P<0.05);术后7 d观察组患者的TBil、白蛋白(albnmin,Alb)、C反应蛋白(C-reactionprotein,CRP)、ALT及ALP与对照组比较差异无统计学意义。观察组患者的平均住院时间比对照组明显缩短(P<0.05)。观察组与对照组的并发症发生率差别无统计学意义。结论术前行胆汁回输联合肠内营养治疗对肝门部胆管癌根治性切除术可产生积极作用,安全性高,能促进患者术后康复。

Objective To explore the application values of preoperative bile reinfusion combined with enteral nutrition for radical resection of hilar cholangiocarcinoma. Methods 53 patients with hilar cholangiocarcinoma treated with radical resection were selected and divided into observation group（n=24） and control group（n=29） according to preoperative treatment. The control group only received conventional therapy, while observation group received preoperative bile reinfusion combined with enteral nutrition in addition. Operation time, intraoperative bleeding volume, liver function, postoperative hospitalization time and complications in two groups were observed and compared. Results The levels of total bilirubin（TBil）, alanine aminotransferase（ALT） and alkaline phosphatase（ALP） at the day before operation were lower than on admission in observation group（P〈0.05）. Operation time, intraoperative bleeding volume in observation group were better than control group（P〈0.05）. The levels of TBil, albnmin（Alb）, C-reactionprotein（CRP）, ALT and ALP were not different between two groups（P〈0.05）. The average postoperative hospitalization time in observation group was shorter than control group（P〈0.05）. There was no difference of the incidence of complications between observation group and control group（P〈0.05）. Conclusion Preoperative bile reinfusion combined with enteral nutrition could play a positive role for radical resection of hilar cholangiocarcinoma with high safety and promotion of promotion of postoperative recovery.